Abstract

Tuberculosis is one of the top concerns in the world and acutely threatens human health. A new potent candidate regimen containing pyrazinamide (PZA), ethambutol (EMB), protionamide (PTO) and clofazimine (CFZ) was proposed by Parabolic Response Surface/Feedback System Control (FSC/PRS) system and showed excellent outcomes in vitro and vivo studies. Here, a convenient liquid chromatography coupled with tandem mass spectrometry (LC–MS/MS) method was developed for the simultaneously determination of four compounds in beagle dog plasma. The plasma samples, 50 μL for each, were pretreated by methanol on 96-well format plates and a further dilution step was designed to reduce predictable matrix effect and lessen the burden of subsequent analysis. The chromatographic separation was achieved on an Agilent SB-Aq column (4.6 mm × 150 mm, 5 μm) at 30 °C by a gradient elution within 6 min. The mobile phase was a mixture of 0.2% formic acid-5 mM ammonium acetate aqueous solution (phase A) and 0.2% formic acid methanol (phase B) with a total flow rate of 1 mL/min. The 30% of post-column eluant was injected into mass spectrometer, equipped with electrospray ionization (ESI) source under positive mode and multiple-reaction monitoring (MRM). This quantification method was proved to be satisfied in selectivity, accuracy, precision, linearity (r2 > 0.998), recovery, matrix effect and stability. Under the specialized conditions, the calibration curves ranged from 20 to 5000 ng/mL for PZA, 1 to 500 ng/mL for EMB, 1 to 500 ng/mL for PTO, and 1 to 200 ng/mL for CFZ. The quantitative accuracy was further assessed under different degrees of hemolyses in detail. This method was proved to be robust and efficient, and successfully applied to the pharmacokinetic study of the new regimen in Beagle dogs.

Highlights

  • IntroductionMore potent chemical entities and regimens are urgently needed to conduct a shorter course of treatment for both sensitive and multidrug-resistant TB (MDR-TB) to promote clinical efficacy and lessen side-effect burden [3]

  • The selection of ionization mode was based on the obtained sensitivity with electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) source

  • The results showed that ESI operated in positive mode provided increased intensity for the analytes compared to APCI

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Summary

Introduction

More potent chemical entities and regimens are urgently needed to conduct a shorter course of treatment for both sensitive and MDR-TB to promote clinical efficacy and lessen side-effect burden [3]. Developing a brand-new compound for TB is a costly and endless course, generally containing preclinical study, phase I, II and III. In view of the multidrug treatment has been widely accepted and recommended by World Health Organization (WHO), it may be a valuable approach to regroup the marketed and under-developed drugs to exploit the latent synergistic effect and maximize anti-TB efficacy. The current multidrug regimen is proposed on the basis of empiric evidence without detailed studies of optimal combinations or dose proportions. To identify the most efficacious 3-/4-drug combinations under optimal drug-dosage ratios, huge and tedious tasks are required because of a big candidate pool of anti-TB drugs (marketed and under developed) and the number of combinations can be exponentially large

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